Requirements for a Comparable Insurance Plan
In order for a health plan to meet the mandatory health insurance requirement, the plan must have at a minimum:
- A deductible not greater than $500 per policy year or $200 per individual illness or injury.
- Coverage at 80 percent of Covered Medical Expenses, payable up to $50,000 for each illness/injury.
- Coverage at 100 percent of additional Covered Medical Expenses over $50,000, until a maximum benefit amount of $250,000 for each illness/injury has been paid.
- Coverage for mental health expenses:
* Inpatient – minimum of fourteen days of hospital confinement covered
* Outpatient – 80 percent coverage up to $3,500
- Coverage that allows patient to receive emergency, specialist and inpatient care, and diagnostic testing and procedures in Atlanta, GA.
- Coverage for medical evacuation and repatriation of remains to the Insured Person’s place of residence in his or her home country ($10,000 for evacuation; $7,500 for repatriation).
- Underwriting by an insurance company domiciled in the United States.
U.S. Dept. of State regulations state that all J-1 exchange visitors and their J-2 dependents must have adequate health coverage in the U.S. as of September 1, 1994, and also specify minimum coverage. If you are a J-1 Student, the plan must also meet one or more of the following criteria:
- Part of a group benefits program offered to enrolled students by a designated sponsor or
- A health maintenance organization (HMO) that is federally qualified as determined by the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services or
- A Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services or
- Underwritten by an insurance company having an AM Best rating of "A-" or above. An Insurance Solvency International, LTD. (ISI) rating of "A-" or above, a Standard & Poor’s Claims-paying Ability rating of "A-" or above, or a Weiss Research, Inc Rating of "B+" or above